Who can own a med spa in Ontario?

A med spa sits between a beauty business and a health practice. The business side (the lease, the equipment, the brand, the booking system) can usually be owned like any other company. The clinical side is governed by who is legally authorized to do each treatment.

Can someone who isn’t a doctor or nurse own a med spa?

Generally, yes. Section 27 of the Regulated Health Professions Act, 1991 controls who may perform a controlled act in the course of providing health care, not who owns the business where it happens. A controlled act may only be performed by a member of a regulated profession whose Act authorizes it, or by someone the act has been delegated to by that member.

That puts the risk on the owner as an employer. Under section 42, the employer of a person who performs a controlled act without authority while acting within the scope of their employment commits an offence, with fines of up to $25,000 for a first offence. If the employer is a corporation, every director who approved of, permitted or acquiesced in it can also be charged.

The professionals you work with have their own rules. For physicians, permitting, counselling or assisting a person who isn’t a member of the College to perform acts that should be performed by a member is professional misconduct under the Medicine Act’s professional misconduct regulation. A physician or nurse practitioner who agrees to be your medical director will look closely at how your clinic is run, because their licence is on the line.

What does the owner control, and what stays with the professionals?

Usually the business owner	Stays with the regulated professionals
The lease, fit-out and equipment purchases	Assessing clients and deciding whether a treatment is appropriate
Brand, website, booking and pricing	Orders, directives and any delegation of controlled acts
Hiring front-desk and non-clinical staff	Informed consent for the procedures they perform
Supplier and software contracts	Clinical records and documentation to their college’s standards
Written policies, with clinical input	Managing complications and adverse events

The College of Nurses of Ontario’s Aesthetic Services guideline expects employers to have written policies on topics including emergency response, infection control, consent, the use of client photos, identifying the health information custodian and any use of unregulated staff. It also says nurses remain accountable to their own standards whatever their employer’s policies say.

Can a doctor or nurse co-own a professional corporation with me?

No. If a physician, nurse or other regulated professional practises through a professional corporation, Ontario’s Business Corporations Act requires all of its shares to be owned by members of the same profession, all of its officers and directors to be shareholders, and its articles to limit it to the practice of the profession and related activities. Agreements that let a non-shareholder vote its shares are void.

Physicians and dentists have a narrow exception under O. Reg. 665/05: a spouse, child or parent, or a trust for minor children, can hold non-voting shares. Outside investors can’t. See how a health profession corporation works.

So a business owner and a clinician who want to work together usually keep separate entities, with written agreements between them about services, fees, space and staff, rather than sharing the clinician’s professional corporation.

Do med spa premises need a licence or inspection?

It depends on what you do. Some examples:

• Physician procedures under anaesthesia or sedation. CPSO’s Out-of-Hospital Premises Inspection Program covers procedures under general or regional anaesthesia or parenteral sedation, and some cosmetic procedures under local anaesthetic, such as injecting permanent fillers. It says botulinum toxin injections, temporary and semi-permanent fillers such as hyaluronic acid fillers, platelet rich plasma injections, laser skin resurfacing and sclerotherapy aren’t captured.
• Esthetic services. The Health Protection and Promotion Act defines a personal service setting to include premises offering electrolysis and other aesthetic services where there’s a risk of exposure to blood or body fluids. Under O. Reg. 136/18, operators must give the local medical officer of health written notice at least 14 days before opening. The regulation doesn’t apply to settings where services are primarily provided by regulated health professionals practising their profession.
• Lasers. Health Canada publishes safety guidelines for laser hair removal facilities, including a laser safety program.

Check your municipality’s business licensing rules as well.

What rules apply to med spa advertising?

Botulinum toxin is a prescription drug, and section C.01.044 of the Food and Drug Regulations limits advertising a prescription drug to the public to its brand name, proper name, common name, price and quantity. CNO’s guideline says nurses’ aesthetic advertising should name the nurse, their designation and their authorizing provider or medical director, and that images must be the nurse’s own work and not retouched. See social media and advertising for clinics and med spas and what health claims a wellness business can make.

What should an owner put in writing?

• A medical director agreement with the physician or nurse practitioner who authorizes treatments.
• Agreements with each injector, nurse and esthetician that match how they actually work. See employee or contractor.
• Intake, consent and privacy documents. See privacy rules for wellness clinics.
• Booking, deposit and cancellation terms clients accept before they book.

What to do next

We review medical director, practitioner and supplier agreements as a contract review, starting at $400, and prepare clinic privacy and consent documents starting at $1,480. A new medical director and practitioner agreement starts at $600.

This guide is general information about Ontario law, not legal advice for your situation. Your clinicians should also check their own college’s current standards. To talk through your clinic’s structure, book a free 15-minute consult.